Some weeks the blogs I read mirror my own preoccupations, serving as a kind of virtual mood-ring if you will. This week, several posts addressing different aspects of professionalism caught my cast of mind exactly:
Bongi admitted to giving in to professional aggression once provoked by an overstepping radiologist. I can't blame him for the big Put Down.
Ramona went the extra mile to ensure a patient didn't have to pay extra money out of pocket. One thing Dr. Bates did not mention in her post is that she didn't make a dime for all her thoughtful efforts.
Dr. Happy reported the unexpected pleasure of discovering a thorough job done by a consulting surgeon. I like to do small things to help out my physician colleagues, and I like it even better when these favors are returned.
Liana at Med Valley High spoke out against rude, can't-be-bothered consultants. Remember: there are no dumb questions, only bad teachers who would rather degrade the questioner than inform their mind.
Buckeye Surgeon wrote about a case of premature designation of comfort care. The decision to withdraw care is one which should be made after close discussion with all of the consulting physicians. On the flip side, I don't think a consultant should undermine a well-informed decision to present comfort care as an option to a patient's family.
Professionalism demands respect in return. Emergiblog's Kim spelled out her expectations for ER etiquette.
An example of professionalism: keeping a straight face when you see some of the strange things doctors see, such as:
- Cauliflower ears (h/t/ to Suture for a Living)
- Concealed weapons (thank you for the important safety tip, Dr. Shadowfax)
- Unidentified rectal accessories, later revealed to be a common workshop item (another cocktail party icebreaker from Shadowfax)
And, since doctors have been known to snarl about hospital administration's budget decisions, let Paul Levy's thoughtful analysis of the revenue/cost scenario at BIDMC be a reminder that we're all working on the same side here.
Let's be good to each other, people. It's a jungle out there.
That's a good point, anonymous. I suspect Dr. Happy filled in the rest of the discharge info, if anything was missing. That's the hospitalist's responsibility.
It is wonderful, however, when a specialist provides all the discharge information/instructions pertaining to the area of specialty, either in the progress note or in the discharge instructions. It is also wonderful if a specialist takes a quick look at the other medications a patient is receiving and gives input into any dose adjustments or changes that should be made, so the hospitalist doesn't have to chase down that information in a separate phone call.
Posted by: Theresa | August 10, 2008 at 08:42 AM
you know, i have to disagree slightly with happy's appreciation for someone else doing the discharge part of his job for him. of course i don't know specifics, but frequently specialists only know one aspect of the ongoing care. were all the appropriate followup's made? were the right medication adjustments made? was the family communicated with appropriately? if happy has to check up on all these things he might as well do the discharge himself. if he didn't bother to double check, well that is potentially sloppy work. jmo.
the reason i (as a specialist) don't do discharges for patients i am consulting on anymore is because i frequently find myself getting a ton of calls from other people-from pharmacies, from primary doc, etc. asking questions i don't know the answers to.
Posted by: anonymous | August 10, 2008 at 08:05 AM
Thanks you for the mentions, Theresa. You continue to write such fine posts.
Posted by: rlbates | August 09, 2008 at 07:39 AM